Prominent ears & misshapen ears / Otoplasty / Pinnaplasty
Prominent ear correction is an operation which used to be widely available on the NHS. Many people came because of unwanted name calling. Often adults who come to see me report having to hide their ears for the whole of their childhood.
This procedure involves making a short cut hidden behind the ear and through this cut addressing the areas which need correcting. This involves moulding the cartilage, removing excess cartilage and repositioning the upper and lower poles of the ear.
Diagram of Areas which might require correction:
Just the left side was operated on. But they end up being pretty much the same.
and here just the right ear again a big smile
both ears and a big smile!!!
Even small corrections can make a difference. Having narrower ears makes your eyes look further apart. This needs to be considered in people with wide cheek bones as over correcting the ears will make the face look wide.
Often the shape of the head makes things more obvious. Here the ears follow the jaw line as the head turns the corner. The folds in the ear are normal but the “bowl” (conchal fossa) is deep.
When ears don’t start the same it is more likely they may not end the same. Here subtle asymmetry persists.
What I like is the much greater confidence in the facial expression in front of the camera
The Operation and hospital stay Otoplasty
The operation takes about 1 ½ hours and is best done under a General Anaesthetic, although it can be performed under Local Anaesthetic injections. If it is done under Local Anaesthetic there is a small risk that people find it unpleasant and this can make the surgery more difficult as the client can be distressed.
What can go wrong with Otoplasty
I feel it is important that anyone having surgery with me is aware of the possible negative sides of surgery and understands the small but real risks. The following paragraphs cover what happens when things occasionally don’t go as expected.
Like all surgery there are risks of complications whoever does your surgery. It is important you are aware that many of the problems you may get after your surgery if they are treated promptly have no obvious effect on the final outcome.
All otoplasty operations have a risk of (in order that they may occur):
• Bleeding: this may lead to more extensive bruising and swelling, but is unlikely to affect the final result. It is uncommon. There is a very remote possibility that the bleeding may require a return to the operating theatre.
• Infection: there is a very small risk of wound infection which would be expected to respond readily to antibiotics but may require a return to the operating theatre.
• Breakdown of the skin over the ears. This is normally in a small area over the cartilage and responds to dressings. Occasionally (less than 2%) further surgery is required to correct it.
• Asymmetry. Your ears are almost certainly not identical before the operation and will be different after the operation. This difference should be subtle and not attract attention. Sometimes the difference is enough to require re-operation (less that 2%)
• Poor scars: this is rare (less than 2%) although it is not uncommon for the scars to become slightly more visible for a while around the 6 -10 week mark. Treatment which works in most cases is available if this is troublesome.
• Sensation changes in the ear and cold sensitivity can last for several months.
• As this is a surgical procedure to deal with appearance no guarantee can be given to the final appearance, but if we agree it is an unsatisfactory result correction will be offered at no additional cost.
• All operations can result in longterm discomfort.
• All operations have a small risk of Deep Vein Thrombosis (DVT), chest infection and Pulmonary embolism. Death following elective surgery is exceptionally rare (1:250,000 in fit and well people)
The majority of people who undergo otoplasty are very pleased with the result and feel it makes a very positive change to their appearance.
Expect to feel washed out for a few days after the surgery and to tire quickly although you will return to your normal energy levels in a few weeks.
Assuming recovery is not unusually slow discharge home is the same day.
A head dressing is provided and needs to be worn day and night for 2 weeks then at night for a further 4 weeks. The dressing and stitches are removed in a clinic visit at 2 weeks. I will personally see you at 2, 6 and 12 weeks and 6 and 12 months following surgery and more if required.
What to expect from Otoplasty
Otoplasty makes an immediate and dramatic difference, although it may take around 2 weeks for the bruising to settle and 4 weeks for the swelling to be nearly gone. There may be some discomfort for a few days. Normally 4-6 weeks after the surgery, there is very little swelling or evidence of recent surgery. It may even be quicker than this.
Cost of Otoplasty Surgery
This includes all required follow-up and in the unlikely event you require further treatment due to post-operative problems any further treatment is also included
Post Operative Instructions for Otoplasty
What to bring to hospital
If you would like, bring a family member or friend. Bring some easy to put on bed wear, preferably with front buttons and your own clothes and toiletries and something to pass the time like books, puzzles or some music . The rooms have televisions and there is free Wi-fi.
What to look out for after you have gone home
Before you come into hospital, you will get a package that contains a set of post-operative instructions and a thermometer.
Watch out for redness, swelling, pain, discharge, opening of the wound, fevers, sweating and shaking. Whatch to see if your temperature is above 37.2C and you feel unwell or it is above 37.6C.
If any of the above are seen or any of the information of the instruction sheet call the numbers on the instruction sheet or the hospital you had your operation.
Things to Avoid
The following are medications or herbal medicines to avoid before surgery.
Please disclose all medications (including self prescribed and herbal and vitamin supplements) during the consultation. The following increase the risk of post operative problems.
Roacutane or other vitamin A skin preparations / aspirin / steroids / warfarin / clopidogrel / Brufen / alka-seltzer / Fish oil / Flagyl / anti-rheumatics-arthritics / blood thinners eg persantin / St John’s Wort / Aloe vera / Cimetidine / Vitamin E (>600mg/day) / Vitamin C (>1000mg/day) / alfalfa / arnica / bromelain / calendula / celery / chamomile / cloves / Evening primrose / garlic / ginger / ginko / goji berries / licorice / meadowsweet / diabetes medication / blood pressure medication / diuretics
Most fruit and pickles have aspirin like chemicals in them so avoid large quantities in the two weeks before surgery.
Please remember that if you have any questions or concerns to ask during one of your consultations. Writing questions down is sometimes helpful.
Normally you can re-start driving at around 2 weeks. You are fit to drive if you feel you are fit. I recommend you have someone take you to an industrial zone or supermarket car park late at night so you can attempt driving without risk to others. If you find you can drive without problems you are safe to go out on the road
Depending on how physical the work you do is, you can start working from between 1 and 3 weeks.
If in doubt remember you can always ask for advice.
At home rest is necessary for one week and any strenuous activity, bending, and lifting etc. is to be avoided. You can shower once your dressings are reduced after your first appointment.
Physical exercise more than a gentle walk should be avoided for the first least 3 weeks and then only undertaken if comfortable. After 3 weeks I allow swimming and cycling and more vigorous walking. After 6 weeks you can, if it is comfortable, return to full activities.